Developing an Outcomes Model for Disabled Children in Scotland

Appendix B Some More Outcomes Models

This section provides descriptions of further outcomes models, including several that have been influential for people developing new models or that are frequently cited.

Barnardo's

This is a significant source model for many projects.

Angus Local Community Planning

This is a well-developed model that was designed to be flexible enough to use in a variety of situations with a variety of people. It aims to be compliant with the GIRFEC national practice model.

Moray Council

"Moray Council has been using the 'Realistic Evaluation' approach for over ten years, within Children and Families Social Work Services, where a questionnaire based on the GIRFEC My World Triangle was developed, as well as within its Youth Justice Team." (CCPS 2010).

Health Scotland: National Parenting Strategy

This model was commissioned by Early Years and Social Services Workforce Directorate of the Scottish Government and is being completed within the Evaluation Team at NHS Health Scotland. This is a work in progress and the next draft is due during 2013.

• The policy context: developing an outcomes-focussed approach to the development and implementation of the National Parenting Strategy (NPS), which in turn has a focus on supporting parents as a key way of improving the life chances of children.
• The purpose is to link local activities with the National Performance Framework (NPF), to align intended outcomes, to identify issues and how partners might work together.
• The target audience includes both national policy makers and local planning partners (Community Planning Partnerships).
• The approach is based on a "logic model" and "results chains". Multiple results chains show the contribution of different sectors to achieving higher level outcomes; an outcomes triangle provides an overview of the topic area; logic models; and, results chains make explicit the link between activities and outcomes, as well as interconnections between outcomes.
• Issues:
  • "Often presented with equivocal evidence, use of different terminologies, definitions and outcome measures, uncertainty about direction of causality and attribution of outcomes to activities."
  • There is a need for clarity about the language to see what is an outcome for the child/ parent/ community.
  • There is a divergence on the use of terminology and language with the range of "Intermediate" to "long-term outcomes" being about movement between levels, not about timescale for individuals.
  • The model does not at present connect to the level of individual families and children, nor is it about disabled children or families with disabled children (although this is a significant population among "parents").
  • The outcomes are not framed in terms of the GIRFEC SHANARRI indicators.

Generic models

Realist Evaluation/Real Time Evaluation

"Realist evaluation" measures and evaluates service intervention and delivery. Service users complete questionnaires that record how individuals feel and how this changes over time. The person's progress is fed back into the service planning process, including the extent to which the objective of intervention has been met." The system is being used by the Aberlour Child Care Trust and by Moray Council. The approach requires external validation by an academic partner, namely, Dr M.F.Kazi (University of Buffalo, New York).

Further information: http://www.ccpscotland.org/assets/files/hseu/information/Better%20Futures/Aberlour%20evaluation%20strategy_%20CCPS%202010.doc

Outcomes Star

This model was developed by the London Housing Foundation to chart changes in the lives of people using services aimed at more independent living. It can be used with a paper-based system or with an electronic recording tool. The Outcomes Star has been further developed and applied to a range of situations (currently 14 versions) one of which is the Autism Spectrum Star, developed in England.

Autism Spectrum Star

This was instigated because "service commissioners were emphasising that they needed a specific autism outcome measurement tool to assess how service users were working their way through their care pathway" and was the "first outcomes measurement tool to help assess the progress and changing needs and abilities of people with autism who are in care". Traditionally autism professionals have had to use a "generic outcomes measurement tool designed for people with mental health problems or learning disabilities but these are inaccurate with autism spectrum conditions."

This version was developed during seminars involving professionals and service users facilitated by Triangle Consulting. The outcomes developed include nine "Journey of Change" areas: physical health; living skills and self-care; wellbeing and self-esteem; sensory differences; communication; social skills; relationships; socially responsible behaviour; time and activities. The Star allows service users to work alongside professionals in rating their abilities on a spectrum from 1-10 in the Journey of Change areas. It can be computer-generated. It has been piloted with 92 people and a professional and is now being implemented.

Further information: Hahn, S. (2012) "Gonna make you a star: how the world's first autism measurement tool, the spectrum star, was created", Learning Disability Today, December 2012 (30-31). www.outcomesstar.org.uk/work/

Other models listed in CCPS (2010) but not described here include:

• Better Futures: Housing. www.ccpscotland.org/hseu/information/better-futures
• ASCOT: Adult Social Care Outcomes Toolkit. Improvement in the use of services www.pssru.ac.uk/ascot
• REACH Standards in Supported Living: For people with learning disabilities to check the quality of their own support and housing: www.paradigm-uk.org
• Social Return on Investment (SROI): Measuring social, environmental and economic outcomes, expressed in monetary terms. www.sroiproject.org.uk
• Carista/Intrelate: A web browser based modular database system designed for social care: www.intrelate.com/?mid=68